Digital Commons Network^™

Pelvic Inflammatory Disease: A Narrative Review Of Disparities Between Black And White Women In The United States And Strategies For Improvement, Lynne Li, Jessica Schlewitt

Journal of Patient-Centered Research and Reviews

Pelvic Inflammatory Disease (PID) is an inflammatory syndrome of the upper female reproductive organs caused by infection, most commonly via Neisseria gonorrhoeae or Chlamydia trachomatis, spreading to one or more reproductive organs. With PID responsible for many of the major morbidities of sexually transmitted infections (STIs), such as ectopic pregnancy and chronic pelvic pain, the urgency is high to mitigate the impacts of untreated PID, especially in higher-risk populations. This paper discusses the current disparities in PID diagnosis, treatment, and management between Black and white women and proposes interventions to reduce health inequalities involving PID. To conduct this narrative review, …

Introducing The Ppco Framework, Children's Health

PPCO Resources & Education

Haven't heard of the PPCO Framework yet? It is a framework developed by nurses for nurses that fits nursing questions when searching for literature to support EBP. 

To learn just a little more, we've created a short cheat sheet, with tips, and some examples, and most importantly - links to the original works.

Evaluation Of Prosthetic And Orthotic Technologies Using Ai Technology, Iris Reyna, Samerial Brown, Gary Guerra, Ed Khu

Posters - 2026

Individuals with lower limb prosthetics have amputations and abnormal limb motions, which poses a high risk of injury when doing everyday activities. In this field, evaluation of individuals' prosthetics are done through biomechanical analysis and gait analysis. This analysis is used to study human movement and evaluate the mobility and quality of life of amputee patients as well as determining the modifications, positioning, and alignment needed to ensure stability with prosthetic and orthotic technologies (Kumar & Bhowmik, 2024). Trunk flexion has importance to the study because of its impact on lower limb kinetics, kinematics, the increase of ground reaction forces, …

Robin Mckenzie Method For Lumbar Disc Herniation And Low Back Pain, Abby Richards, Christopher Hurt

Expo Student Presentations

2026 Spring Expo Poster Presentation

• Health Sciences & Health Professions

Deep Learning Based Approaches For Low Cost Defense Detection, Adele J. Noel-Rickert

All NMU Master's Theses

Pulmonary fibrosis is a progressive interstitial lung disease characterized by the accumulation of fibrotic tissue within the lungs, leading to impaired respiratory function and reduced quality of life. Early detection is important for disease management; however, accurate diagnosis often relies on high-resolution computed tomography (CT), which may not be accessible in all clinical settings. Chest radiography provides a lower-cost and widely available imaging modality, but interpretation of chest X-rays for fibrotic disease can be challenging due to subtle radiographic patterns and overlapping anatomical structures. This thesis investigates the use of multimodal deep learning techniques to assist in pul- monary fibrosis …

Space-Time Analysis Of Burgeoning Us Atrial Septal Defect Rates Driven By Cannabis, Albert Stuart Reece, Kenneth Hulse

Research outputs 2022 to 2026

Atrial septal defect (ASD) has become increasingly common in the USA and now affects 1 in 11.3 children in some places, but space–time analysis has not been applied to this emerging trend. ASD rate (ASDR) data were obtained from the National Birth Defects Prevention Network 2003–2020. Substance (cigarettes, alcohol, cannabis, analgesics, cocaine) use data were obtained from the National Survey of Drug Use and Health. Income data were obtained from the US Census. Analysis was limited to the Non-Hispanic White population by technical factors. Time-sequential univariate and bivariate maps were prepared for both covariates and outcomes and their combinations. Spatial …

Reducing Computed Tomography Delay In A High-Volume Emergency Department, Sarah Ouedraogo

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem:

Delays in computed tomography (CT) imaging contribute to prolonged emergency department (ED) length of stay and delayed clinical decision-making. At the project site, baseline data demonstrated an average ASAP CT order-to-scan time of approximately 116 minutes for non-critical ED patients, with CT readiness compliance rates of 0%. Gap analysis identified inconsistent patient preparation and fragmented communication between ED nursing and radiology as key contributors to avoidable delays. PICOT question: In non-emergent emergency department (ED) patients (P), how does the use of a CT readiness checklist by ED nurses (I), compared with no standardized readiness checklist (C), affect patient readiness …

A Critical Narrative Review Appraisal Of The 2025–2030 Dietary Guidelines: Scientific Strengths, Conceptual Gaps, And Overlooked Dimensions Of Sustainability And Health Equity, Dimitrios Papandreou, Azza Alsuwaidi, Zainab Taha, Constantinos Giaginis, Georgios K. Vasios, Eleni P. Andreou

All Works

The 2025–2030 Dietary Guidelines introduce an important shift in public health nutrition, emphasizing minimally processed foods, higher protein intake, greater inclusion of full-fat dairy, and a food-based advice centered on “real food” consumption. While several of these recommendations align with accumulating evidence, particularly the discouragement of ultra-processed foods and added sugars, substantial concerns remain regarding their internal coherence, population-level applicability, risk of misinterpretation, as well as environmental footprint. This critical narrative review evaluates whether the scope, emphasis, and framing of the new guideline components are proportionate to the strength, consistency, and context of the underlying evidence. Using a novel framework …

Endocrine Roles Of Vitamin D In Female Reproduction: Mechanisms And Clinical Implications, Azza Alsuwaidi, Fatme Alanouti, Dimitrios Papandreou

All Works

Vitamin D a fat-soluble steroid hormone signals through Vitamin D Receptors (VDRs) located throughout the ovaries, uterus, placenta, hypothalamus, and pituitary gland, influencing immune regulation and female reproductive physiology. This review of studies from 2013-2025 found consistent associations between low vitamin D status and various disorders in women of childbearing age. In Premenstrual Syndrome (PMS), deficiency correlates with higher symptom severity, and evidence shows that supplementation significantly reduces total PMS scores, particularly improving mood-related domains. For uterine pathologies such as fibroids, endometriosis, and adenomyosis, low vitamin D status is linked to increased risk and severity. Repletion trials suggest antifibrotic and …

Language Barriers In The Healthcare System, Gulten Altunbulak

Student Capstone Papers

Language barriers in healthcare can negatively affect quality of care, patient satisfaction, and health equity, particularly among individuals with limited English proficiency (LEP). This capstone project aimed to develop and implement an occupational therapy communication protocol in a skilled nursing facility to address these barriers. A mixed-methods approach was used, including a pre-survey of 25 staff members, post-implementation interviews, and observational feedback to evaluate communication practices, interpreter use, and staff confidence. Interventions included staff education on interpreter services and culturally responsive care, as well as bilingual communication tools, personalized resident posters, and a Language Line training video. Guided by the …

We Are Each One Second Away From Being Someone Else's Patient, Paul B. Freeman Od

Optometric Clinical Practice

Editorial

Birdshot Chorioretinopathy: A Review Of Diagnosis And Treatment, Jill Gottehrer Od, Steven Follansbee Od

Optometric Clinical Practice

Background: Birdshot chorioretinopathy is a rare, bilateral chronic uveitis resulting in choroidal and retinal inflammation in the form of vasculitis, papillitis, and/or macular edema. For an accurate diagnosis, a thorough patient history, fundoscopic exam, and appropriate ancillary testing are necessary.

Case Report: A 49-year-old male presented to the eye clinic due to vitreous floaters in both eyes that had worsened over the last year. The patient was new to the clinic with no prior history of eye examinations. At presentation, a mild vitritis was noted along with small, multiple white dots in the posterior pole of both eyes. Ancillary testing, …

A Case Of Adolescent Papilledema Secondary To Oral Hormonal Contraceptives, John D. Tassinari Od, Phil Kwok Od

Optometric Clinical Practice

Background: Papilledema, optic disc swelling secondary to elevated intracranial pressure (ICP), is a medical emergency given the gravity of possible disease etiologies, including but not limited to intracranial mass.

Case Report: A 12-year-old female with normal body mass index developed marked headaches and subsequently manifested bilateral swelling of the optic discs and retinal folds. Scanning laser ophthalmoscopy, particularly in the fundus autofluorescence mode, provided a striking image of the retinal folds. The posterior segment abnormalities were accompanied by reduced visual acuity and corresponding visual field defects. The edema of the optic nerve and retinal fluid were worse in her left …

Reducing Unplanned Copd Readmissions Through Utilization Of A Nursing Discharge Checklist, Rachael Mcallister

Doctor of Nursing Practice Final Project Abstract

PURPOSE

The quality improvement (QI) project aimed to decrease readmission rates at the project site through implementation of a nurse-driven disease-specific discharge checklist when compared to the same timeframe the year prior.

BACKGROUND

The project site’s 2024 national ranking declined due to unplanned chronic obstructive pulmonary disease (COPD) readmissions. COPD readmissions remained at national average and was not nationally competitive. This metric increased cost to the hospital and contributed to worse quality outcomes for the patient.

METHODOLOGY

Project design used the IOWA Model Revised framework and supported with an evidence-based review of the literature. PDSA cycles were conducted during implementation. …

Optimizing Vbac Outcomes Through A Structured Tolac Pathway, Alexandra E. Williams

Doctor of Nursing Practice Final Project Abstract

Evaluate whether implementing a structured TOLAC clinical pathway improves VBAC success, increases TOLAC attempts among eligible patients, and improves maternal and neonatal outcomes. The project was conducted at a Southeast hospital in Houston, Texas. 

Women with a prior cesarean often have limited labor options because many hospitals default to repeat cesarean delivery. TOLAC remains underutilized due to safety concerns, limited provider education, and lack of standardized protocols. Evidence shows that appropriate counseling, standardized management, and close maternal–fetal monitoring can support safe vaginal birth after cesarean (VBAC).

A pre–post implementation design guided by the RE-AIM framework was used. Eligible participants included …

Streamlining Patient Workflow: Enhancing The Screening Process For Social Determinants Of Health To Ensure Consistent Patient Intake In A Medical Clinic, Candice L. Bruce

Doctor of Nursing Practice Final Project Abstract

Purpose: The purpose of this quality improvement project was to increase social determinants of health (SDOH) screening rates by incorporating an enhanced patient history form into the patient intake process in a women’s health clinic.

Background: The project was implemented in a small, rural clinic led by advanced practice providers that is affiliated with a large academic healthcare institution in southeast Texas. Addressing SDOH is essential for improving health outcomes and supporting value-based care initiatives, yet screening is often inconsistent in outpatient settings.

Methodology: The Plan–Do–Study–Act (PDSA) framework was used for implementation. A brief SDOH screening tool was embedded …

Hlt 101 Introduction To Public Health, Elyse Gruttadauria

Open Educational Resources

The syllabus, created by Professor Elyse Gruttadauria as part of the CUNY OER Initiatives for HLT 101 contains a course description, course objectives, course readings divided by week and a link to four OER textbooks.

Factors Associated With Lapses In Care Among People Living With Hiv In South Carolina, Xueying Yang Ph.D., Fanghui Shi, Shujie Chen, Gavi Samuel, Bankole Olatosi Ph.D., Sharon Weissman, Xiaoming Li Ph.D., Jiajia Zhang Ph.D.

Faculty Publications

Utilizing statewide electronic health records (EHR) data, this study aims to assess the factors determining the occurrence of lapses in HIV care among people with HIV (PWH) in South Carolina (SC). All adult (≥ 18 years old) PWH who were diagnosed with HIV between 2006 and 2018 with at least two HIV care encounters and at least 1-year follow-up record were included in the analysis. The outcome, a lapse in care, was defined as a repeated measure of HIV care encounter that occurs over a year following the previous visit. Generalized Estimation Equation models were employed. The study cohort had …

Lessons Learned From The Implementation Of A Pragmatic Trial Evaluating Non-Pharmacological Approaches To Dementia Care In Us Nursing Homes, Carin Wong, Catherine V. Piersol, Felicia Chew, Cara Lekovitch, Victoria Shier, Mike Morris, Jenny Martínez, Julie Britton, Natalie E. Leland

Department of Occupational Therapy Faculty Papers

RATIONALE: The consistent delivery of effective evidence into nursing home practice has been shown to enhance quality of care and residents' outcomes. Pragmatic trials enable the evaluation of efficacious interventions in a real-world context, including care of residents living with Alzheimer's Disease and Related Dementias (ADRD). Yet, there are limited pragmatic trials conducted in nursing homes and even less evidence on the strategies to successfully conduct such research in this setting.

OBJECTIVE: To identify the lessons learned from a pragmatic trial and provide recommendations for future successful studies in United States (US) nursing homes.

METHODS: Drawing on a case example …

Shaping The Medical Educators Of Tomorrow: Developing Residents' Teaching And Educational Scholarship Skills, Devang Pastakia, Jen King, Alyssa Schlotman, Ryan Hanson, Kyle Langford, Lauren Starnes, Ryan Wolf, Tara Minor

Presentations

It is widely accepted that residents play an integral role in educating medical students.1 It is estimated that medical students receive approximately one-third of their clinical education from residents.2 It has been demonstrated that good education from residents positively impacts medical student clerkship satisfaction and influences career choices.2 Despite the fact that residents participate in educational responsibilities and many residents want to incorporate medical education into their future careers, residencies often do not have programs that provide a foundation for developing future medical educators.3 Dedicated programs may also serve as an avenue through which residents can explore medical education careers …

Exploring How Parental Involvement Impacts Police Encounters And Delinquent Behaviors Among Black Adolescent Girls, Danielle Porter, Elizabeth A. Otto, Dyamon Brown, Jasmine Alli, Robyn Douglas, Noni Gaylord-Harden

Presentations

Adolescents’ contact with police is a complex outcome that is influenced by both individual behavior and the broader social context. Specifically, while delinquent behavior can lead to more police contact (Crutchfield et al., 2012), hyper-surveillance often occurs in marginalized communities, increasing unjustified police contact for youth of color (Campos-Manzo et al., 2020; Geller, 2021). Indeed, racial disparities in police contact during adolescence persist even after accounting for delinquent behavior (Campos-Manzo et al., 2020; Crutchfield et al., 2012). Thus, it is important to identify factors that may protect Black youth from contact with police. Parental involvement refers to parents’ active and …

Antibiotic-Pathogen Concordance In Pediatric Complicated Community-Acquired Pneumonia, Makenna Steger Md, Marina Dantas Md, Mscr, Berina Karisik Do, Smit Shah, Alaina Burns Pharmd, Jessica Markham

Presentations

Background Complicated community-acquired pneumonia (cCAP)—defined by effusion, empyema, abscess, cavitation, or necrosis—is associated with worse outcomes than uncomplicated pneumonia. Methicillin resistant Staphylococcus aureus (MRSA) data in cCAP are limited and often merged with uncomplicated cases. Although guidelines recommend MRSA coverage only in select cases, it is empirically used in >70% of encounters. Lack of pathogen identification likely drives overuse due to diagnostic uncertainty. Clarifying Member of AAP, APA, APS, SPR, ASPN, or PIDS? PIDS JM Jessica Markham, MD, MSc Position: Associate Professor of Pediatrics Organization: Children's Mercy Hospitals and Clinics Email: [email protected] Role: Co-Author Disclosure Status: Complete Disclosure: Nothing to …

Alternative Anticoagulation Strategies For Heparin-Intolerant Patients Undergoing Cardiopulmonary Bypass: A Scoping Review Of Patient Outcomes, Zachary Nelson

Student Works

Background/Introduction: Heparin intolerance, most notably heparin-induced thrombocytopenia (HIT), presents a major clinical challenge during cardiopulmonary bypass (CPB), where systemic anticoagulation is essential for safe circulation through the extracorporeal circuit. While several alternative anticoagulants have been described, there is limited consensus regarding their safety, dosing, and outcomes. The objective of this study was to map existing evidence describing alternative anticoagulation strategies for heparin-intolerant adult patients undergoing CPB and to summarize reported patient outcomes, dosing strategies, and intraoperative management considerations.

Methodology: This scoping review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) …

Complex Iliac Artery And Iliocaval Venous Reconstruction Using Temporary, Redundant Graft To Facilitate Resection Of Recurrent Metastatic Sex Stromal Tumor, Shah-Jahan M Dodwad, Blaz Podgorsek, Ezra Koh, Taha S Zaidi, Justin E Bird, Shalin S Patel, Thanila A Macedo, Gustavo S Oderich

Faculty, Staff and Student Publications

We report a complex case of recurrent, metastatic sex cord stromal tumor involving the pelvic vasculature and spinal nerves. Posterior and anterior approaches were required with redo iliac artery reconstruction using a temporary, redundant aortoiliac to right external iliac artery graft and iliocaval venous reconstruction. After completion of tumor resection from nerve structures, reconstruction of the right iliac veins was completed and the redundant aortoiliac arterial graft was shortened. The redundant graft minimized ischemia time, enabling meticulous dissection and tumor removal. This case underscores the importance of multidisciplinary collaboration in managing rare, aggressive malignancies with complex vascular and neural involvement.

Adults And Adolescents With High-Intensity Neurologic Impairment Hospitalized At Children’S Hospitals, Charles Maloy, Matt Hall, Joanna Thomson, Jean-Baptist Lepichon, Henry T. Puls

Posters

Introduction: Children with high-intensity neurologic impairment (HINI) account for a sizeable proportion of inpatient resources. As survival into adulthood for children with medical complexity increases, children’s hospitals will likely admit adults with HINI. Understanding adult HINI hospitalization patterns is necessary to develop effective care strategies for this population. Objective: Compare characteristics of adults and adolescents with HINI hospitalized at children’s hospitals and describe hospital-level variation in hospitalizations for adults with HINI. Methods: This retrospective cross-sectional study included discharges of patients with HINI aged 12-29 years from 41 children’s hospitals in the Pediatric Health Information System between 2022-24. Hospitals were excluded …

Variation In Dexamethasone Prescribing Practices For Pediatric Asthma Exacerbations In Acute Care Settings, Hannah Reilly, Natalie J. Kane, Sian Best, Mark A. Hoffman, Kathryn Kyler

Posters

No abstract provided.

Embodied Horror: Women And Medical Authority In Video Games, Jocilynn Denise Colombo

Comparative Literature M.A. Essays

Through a critical analysis of interactive horror, this paper argues that video games can function as ethical diagnostic narratives that uniquely expose systemic failures surrounding women’s bodies and medical authority. Focusing on Silent Hill 3 (2003) and Alice: Madness Returns (2011), I examine how these games render harm legible through player participation. By requiring players to move characters through hostile environments and make decisions within systems that simultaneously grant and restrict control, these games foster identification and complicity by positioning players directly within the structures they critique.

While feminist horror scholarship—notably from Julia Kristeva and Barbara Creed—has explored societal anxieties …

Occupational Epidemiology Of Acral Lentiginous Melanoma, Lily Guo, Robin Kikuchi, April W. Armstrong, Suephy C. Chen

Department of Dermatology and Cutaneous Biology Faculty Papers

Acral lentiginous melanoma (ALM) classically presents in glabrous skin. Some studies suggest an association between mechanical stress and ALM development. People working jobs with long periods of standing/walking may be exposed to near-daily mechanical stress. To investigate the relationship between occupation type and ALM development, we performed a retrospective cohort study using Optum’s Clinformatics Database (2007—2023). We compared the risk of ALM in adults with occupational data (n = 9,270,935). Retired patients had the highest prevalence (0.081) and incidence per 1,000,000 person-years (0.514, 95% confidence interval = 0.487—0.542) of ALM. We performed multivariate logistic regression, adjusted for demographics and insurance, …

Disseminated Tuberculosis Presenting With A Nodo-Colonic Fistula In A Newly Diagnosed Hiv-Positive Patient: A Case Report From Tanzania, Samina Somji, Salim Surani, Joshua Ngimbwa, Tevin Kahwa, Frank Swai, Fatema Tayabali, Bishoy Rofaeil

Population Health, East Africa

We present the case of a 35-year-old male with no known comorbidities who presented with chronic gastrointestinal (GI) and constitutional symptoms and was empirically treated with several antibiotics during multiple clinic visits at different health facilities. The laboratory test sent included a stool GeneXpert, which was positive for Mycobacterium tuberculosis (MTB). CT imaging revealed multiple necrotic abdominal and retroperitoneal lymph nodes, hypoenhancing splenic lesions, a nodo-colonic fistula between the necrotic retroperitoneal lymph nodes and the adjacent colon, and a mild left-sided pleural effusion. Colonoscopy demonstrated caseating discharge from the fistulous tract 40 cm from the anal verge, and histology showed …

Beyond Parallel Programmes: A Roadmap For Operational Integration Of Family Planning And Nutrition In Low- And Middle-Income Countries, Marleen Temmerman, Samuel Ojong

Centre of Excellence in Women and Child Health

No abstract provided.